Generalized Pustular Psoriasis

Abstract

In the hope that an uncommon view of a common disease might afford new insight, we have closely observed 2 cases of psoriasis in the rare acute pustular phase. We believe that in such generalized pustular psoriasis one can see an enormous magnification, acceleration, and accentuation of what otherwise is a slow, insidious, chronic scaling process. Our observations underscore the belief that the leukocytes must play a significant role in the pathogenesis of this disease, both in its classical micropustular and in its rare macropustular form. <h3>Report of Cases</h3><h3>Case 1.—</h3> One week prior to hospital admission, this 58-year-old woman had developed an acute exacerbation of her long-standing psoriasis. She had had recalcitrant generalized psoriasis for over 16 years, requiring hospitalization on 3 previous occasions. The present attack began as erythematosquamous lesions of her arms and legs. It rapidly spread within a day to involve the chest and back. On examination